Hair Transplants, Testosterone Cypionate & Hair Loss

Hi guys, I am looking for some advice from anyone with some experience with testosterone and hair loss, especially anyone with transplants. I have started to experience hair loss with TRT. Here is my story:

I'm 32. In April 2012, I had a 2,000 graft hair transplant procedure. I plan to have another procedure to fix my crown in 2013. I first noticed hair loss in my early 20s. I have fine, blond hair. The results have been excellent, until I started experiencing hair loss again today. From the procedure until this morning, I experienced no further loss.

I have been on Propecia 1 mg/day since April 2012.

In July 2012, I realized that I was experiencing symptoms of low testosterone for some time. Extreme fatigue, depression, etc. My GP did a full workup and found I did in fact have low testosterone. He found my thyroid fine. On July 26, my results were:
Testosterone Total= 338 (Normal 240-820)
Testosterone Free =7.5 (Normal 8.7-25)

My GP prescribed Fortesta 10 Mg, 4 pumps daily. I didn't really feel much improvement. Had blood retested in September 2012. (On the day of the retest I had not applied the gel so my testosterone came back in the 180s.) The plan was to continue with Fortesta, just to increase the dose. The same day I got my results, I got a moderate-severe skin reaction to the Fortesta in the afternoon. MY GP advised to stop Fortesta and gave me a script for compounded cream - 100 mg/ml, 1 ml/day.

I have insurance, but because my deductible if so high, the cream was costing me $150 a month.

I went back to my GP last Friday. My levels with the compounded cream were:
Testosterone Total= 568 (Normal 240-820)
Testosterone Free =7.5 (Normal 8.7-25)
My estrogen was 30, and the upper limit of the normal range for the lab was 38

While the total testosterone number showed improvement, I physically was not feeling any better. He said that since my free testosterone was unchanged from the July number that I should give the treatment some more time and it should increase with time since the total was up and I will start feeling better.

On Friday, I explained to my GP that I am paying for the cream cash, out-of-pocket, and asked if I could have a script for Testosterone Cypionate. I had done a lot of reading on this and other boards and since a lot of people found good results from Cyp. I wanted to give it a try since it would only cost $3/week vs. $38/week for the cream. He prescribed 200 mg/ml, 0.5 ml/week. I injected the first time Sunday night. I noticed I have been tired for the past two days.

Beginning this morning and throughout the day, I have noticed excessive hair shedding...I mean a lot!!! I noticed even hair from the transplant area shedding excessively beginning this morning, into my hands.

The amount of loss throughout the day has been very excessive. I know that hair loss is a side-effect of Testosterone Cypionate. However, I do not want to jeopardize my transplants or what hair I have left. I did not notice this problem at all with the cream or gel while I used it. Should I stop treatment with the injectable testosterone? Is the injectable too strong for me? What would you recommend, maybe lowering the dose or stopping altogether? What about another gel? Donít Fortesta and Androgel have different inactive ingredients? (While one may cause an allergic reaction, the other may not?)

After some searching, I was reading on a blog that Testosterone Cypionate ester is "more related to DHT than other esters." That blog seems to equate Cypionate with hair loss more than other testosterone esters. (I cannot post the link because I'm still a new member.)

Does anyone have experience with hair loss with Test Cypionate but not other tests such as Ethanate?

Thanks for any help. I have been alarmed since I spent so much on the transplant procedure... I really appreciate anyone chiming in that has some info.

I do injections and my free test didn't rise at the same rate as my total, so I added stinging nettle back in. I used to take it all the time and stopped about a year and a half ago when I was starting TRT lab work. Actually, I would switch between regular stinging nettle and Endosurge. Just adding stinging nettle in increased my free test by about 60%, Endosurge brought it up about 75%, but it should be cycled, so it's not an all the time thing. I take 800mg a day of sn.

Oh, I should add that I had my dad start taking it after his prostate surgery and it has kept his numbers down and he is actually growing hair again. My mom can't believe it, but it is true. Not a lot mind you, but at 73, even seeing 20 new hairs is like christmas.

I do injections and my free test didn't rise at the same rate as my total, so I added stinging nettle back in. I used to take it all the time and stopped about a year and a half ago when I was starting TRT lab work. Actually, I would switch between regular stinging nettle and Endosurge. Just adding stinging nettle in increased my free test by about 60%, Endosurge brought it up about 75%, but it should be cycled, so it's not an all the time thing. I take 800mg a day of sn.

Oh, I should add that I had my dad start taking it after his prostate surgery and it has kept his numbers down and he is actually growing hair again. My mom can't believe it, but it is true. Not a lot mind you, but at 73, even seeing 20 new hairs is like christmas.

May want to look at that or possibly something like a toco product.

Thanks, at this point I am so freaked out by losing this newly transplanted hair that I think I am done with injections. I am still in shock really... It might not be worth it to me after the surgery… I thought because I was not having hair loss problems with the gel and cream that I would be ok. But, it just must have been the small daily dose vs. the large weekly dose that did my scalp in. I wish I could dilute the injection at this point!

The compounded 1% cream was working to increase my total test, albeit expensive. Perhaps I can find a gel my insurance will cover that doesn't give me a skin reaction. I guess I shouldn't have messed with it. I was looking at the cost over the long run...$3/week vs. $38/week for a lifetime adds up.

Thanks for the stinging nettle recommendation. I will have to read up on it. The forum thread on AM I found had arguments for and against its DHT-blocking properties...

I completely understand you wanting / needing to protect your hair investment - it must have been very expensive and probably not all that much fun to endure the procedure.

From my understanding, Test is Test. The medium that Test rides on (esters / cream) is the difference in products we see out there. Bodies are different, so the amount of Test you were absorbing on the cream could be much different than what you get in the injection. 100mg per week of Test could actually be more than you were absorbing via the cream.

I called my doctor and he said that he is surprised by this since hair loss from injectable use usually takes months to appear. Does anyone have experience with hair loss from injectable use and how long it takes before it starts?

I also asked him about DHT-conversion of topicals vs. injectable testosterone. He said that topicals have lesser of an impact on DHT. Does anyone have an opinion or experience on whether or not topicals have less affect on DHT levels than injectables?

I called my doctor and he said that he is surprised by this since hair loss from injectable use usually takes months to appear. Does anyone have experience with hair loss from injectable use and how long it takes before it starts?

I also asked him about DHT-conversion of topicals vs. injectable testosterone. He said that topicals have lesser of an impact on DHT. Does anyone have an opinion or experience on whether or not topicals have less affect on DHT levels than injectables?

Thank you. ^^^ This is what I thought after doing more reading. However, I was starting to consider what my doctor said - that he's found topicals to affect DHT less than injectables - because topicals are out of the body in such a short period of time. He said that was his clinical experience.

I am not a doctor or knowledgable with regard to hormones, but it made sense to me that if the topical testosterone has a shorter half-life than some of the injectable esters, that it could possibly affect DHT less. It made sense to me that it would have less time in the body to affect other substances in the body.

Since Cypionate has such a long acting ester, do you think it's possible for it to have a more profound effect on DHT than a short-acting topical testosterone with a quick-working ester?

Everything i have read indicates topicals have higher conversion to dht than injectable test.

You are aware that the propecia is probably a huge part of the low testosterone?

^^^ This makes sense why my total testosterone was still suppressed even though I have been on TRT treatment since June. Do you know if Propecia has the same effect on total testosterone and free testosterone?

Do you also know if taking Propecia just prevents DHT-conversion while leaving testosterone available for the body? In other words, do you know if it is solely a DHT-suppressor or does it in fact negatively affect testosterone availability/production as well? I was under the assumption that bodybuilders take Finesteride in addition testosterone-boosting compounds to decrease DHT while increasing testosterone for muscle building.

Thanks for your help. You have given me something important to consider and further research.

Matrix and others posted how finasteride had been tied to some pretty horrific side effects as far as hormones, testosterone and sex drive. Some effects lasting for years after as well. I am pretty sure there are some threads on here that may help
I have also read on here that some guys have too low dht on injections. I know my brother has opiate induced hypogonadism and the gels brought test up a little and dht a lot.